That's it in a nutshell. There's nothing wrong with want to see results for the money spent, per se. But evaluating health care isn't as simple as say, finding a good mechanic for your car. Especially when we're talking Medicare. Seniors are going to have a greater disposition towards chronic illness, and conditions that can be managed, but not cured. So, it's not so easy to define "improvement."
I would bet there will be additional political strings, too. We're already seeing the push for doctors to ask about guns in the home, etc. It would probably be a simple matter to define those sorts of actions as treatment or some other positive on the government forms. I really would put nothing past this bunch of statists.
Bottom line is, this is not likely to work. Nothing else this administration has done has been particularly success - at least not in a GOOD way.
The assumption that “quality” of care is the entire responsibility of the doctor only shows ignorance. At best patient compliance is 50 to 70%. Hell, I AM a doctor and I don’t think I have ever taken all ten days of a twice daily antibiotic. Make it three or four times a day and compliance gets even worse. Just getting people to keep appointments is almost impossible.